PT  - JOURNAL ARTICLE
AU  - Patrizio Lancellotti
AU  - Raluca Dulgheru
AU  - Yun Yun Go
AU  - Tadafumi Sugimoto
AU  - Stella Marchetta
AU  - Cécile Oury
AU  - Madalina Garbi
TI  - Stress echocardiography in patients with native valvular heart disease
AID  - 10.1136/heartjnl-2017-311682
DP  - 2017 Dec 07
TA  - Heart
PG  - heartjnl-2017-311682
4099  - http://heart.bmj.com/content/early/2017/12/07/heartjnl-2017-311682.short
4100  - http://heart.bmj.com/content/early/2017/12/07/heartjnl-2017-311682.full
AB  - Valve stress echocardiography (VSE) can be performed as exercise stress echocardiography (ESE) or dobutamine stress echocardiography (DSE) depending on the patient’s clinical status, severity and type of valve disease. ESE combines exercise testing with two-dimensional grey scale and Doppler echocardiography during exercise. Thus, it provides objective assessment of symptomatic status (exercise test), as well as exercise-induced changes of a series of echocardiographic parameters (different depending on the valve disease type), which yield prognostic information in individual patients and help in a better treatment planning. DSE is useful in symptomatic patients with low-gradient aortic stenosis. It clarifies its severity and helps in assessing surgical risk in patients with severe disease and systolic dysfunction. It can be also used to test valve haemodynamics in asymptomatic patients with significant mitral stenosis unable to perform an exercise test or to test the left ventricle response, namely to test viability, in patients with ischaemic secondary mitral regurgitation. VSE has taught us that history taking, clinical examination and resting echocardiography give an ‘incomplete picture’ of the disease in patients presenting with a severe valve disease. Therefore, its use should be encouraged in such patients.